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Cataract treatment & surgery
What are cataracts?
A cataract is when the natural lens within your eye becomes cloudy affecting the way light enters the eye, in turn blurring your vision. Symptoms of cataract can vary but include:
- Reduced vision
- Changes to your glasses prescription
- Glare
- Altered depth perception
- Colours becoming faded
Find out more about cataract surgery in this short video from Dr Andrew Tatham:
What causes cataracts?
Cataracts are very much part of the normal ageing process but can develop earlier in some cases. Some of the causes of cataracts include:
- Diabetes
- Longer term use of steroid medications
- Previous eye surgery or trauma
- A family history of cataracts
- Eye conditions such as Uveitis
The exact cause of cataracts is not fully understood but other factors believed to also cause them, include exposure to ultraviolet, smoking, excessive alcohol consumption and poor diet.
How do you treat cataracts?
To treat cataracts, surgery is the only option. Once your symptoms are sufficiently significant the cloudy lens material is removed and a lens implant is inserted in its place.
By far the most common technique to do this is Phacoemulsification. This type of surgery is carried out as a day procedure and normally under Local Anaesthesia though you may request some sedation or even a general anaesthetic if required.
When should you have cataract surgery?
It is commonly advised to consider cataract surgery when your symptoms start to affect your daily activities, including:
- Driving
- Work
- Hobbies
- Personal safety
Cataracts continue to develop with time, meaning that your vision will get worse if left untreated.
What happens during cataract surgery?
Once your eye is anaesthetised the surgeon will make a very small incision in the cornea (the clear window at the front of your eye). A small probe is inserted through the small incision and emits ultrasound waves to break up the cloudy lens. The lens material is turned to liquid and is gently sucked out through a tube.
Once finished the surgeon will inject in a folded up lens implant which will position itself nicely where the old lens once was. In most cases no stitches are required and the wounds heal by themselves.
What other treatment options are available when having cataract surgery?
Along with removing the cloudy lens, cataract surgery is likely to be a great opportunity to correct or reduce any prescriptions of short sight, long sight and/or astigmatism. Your Surgeon will discuss the options that are available to you, allowing you to choose the best fit for your lifestyle.
Intraocular Lenses (IOLs) can be used in place of the cloudy cataract lens during surgery. The lenses aim to give you sharp vision, assuming your eyes are in otherwise good health.
Regardless of which IOL you choose the surgery itself is almost identical but the lens technologies can vary significantly.
What types of Intraocular Lenses can be used?
Monofocal IOLs
- These lenses aim to give sharp vision at a single distance. For example if the lens is chosen to give clear distance vision then you would need reading glasses. These lenses do not correct astigmatism.
- In some cases each eye can be set at a different focus known as mono vision or blended vision. To ensure you can tolerate this your surgeon may request that your optometrist first trials the outcome by prescribing contact lenses that will mimic the result of surgery.
Aspheric IOLs
- These lenses can be either mono or multifocal and are designed to give the optimal visual result and may also improve vision in lower contrast conditions.
Multifocal /Trifocal /Extended Range IOLs
- If you want a greater degree of freedom from wearing glasses these lenses may be an option. They work in a similar way to multifocal contact lenses and aim to give useful vision for both distance and near viewing.
- If you have other eye problems these lenses may not be suitable, and this will be discussed and explained at your appointment.
TORIC IOLs
- If you suffer from astigmatism then a TORIC IOL may be offered to correct or reduce this. In most cases Astigmatism is when the clear window at the front of your eye (the cornea) is shaped more like half a rugby ball rather than half a football.
- The aim of these lenses is to reduce the astigmatism enough to be less reliant of glasses. A special shaped lens implant is positioned at a certain angle to counter balance the astigmatism in your Cornea.
- Standard Monofocal and Multifocal IOLs do not correct astigmatism, however TORIC IOLs can come in both mono and multifocal.
Are there any side effects to cataract surgery?
You will be able to go home the same day, with the whole appointment lasting around 3 hours
Depending on the type of anaesthetic used the feeling should return to your eye(s) within a few hours of the surgery. However, it can take some days for your vision to start to improve.
On discharge your nurse will go through signs and symptoms of potential problems and how to seek help for them Normal post-surgical symptoms include:
- Watering eyes
- Blurred or double vision
- Gritty eyes or the sensation that a foreign body is present
- Bloodshot or red eyes
- These symptoms normally improve within a few days but can take several weeks to fully recover.
What can affect the results of cataract surgery?
Although a very straightforward and safe procedure there are some small risks of potential complications. These can vary between patients and will explained in detail at your appointment, allowing you to weigh up the pros and cons of cataract surgery before making your decision. Some factors which could affect your results include:
- The presence of other eye conditions
- The accuracy of the measurements taken to choose the intraocular lens power (Biometry)
- The type of IOL used
- The healing process / inflammation
What happens after cataract surgery?
Your nurse will go through a thorough discharge pack with you before you go home. Emergency phone numbers will be issued just in case you have any problems afterwards and your nurse will explain what symptoms to look out for and when to seek help.
You will go home wearing an eye shield or eye pad which you should leave on until the following morning. It may be advised to replace the shield at bedtime for the first week. Your nurse will explain how to remove and bathe your eye each morning.
What should I do and what can’t I do after cataract surgery?
- You will be required to take eye drops for around four weeks after the surgery to prevent infection and inflammation.
- You will be advised to avoid strenuous activity and swimming pools for several weeks after the surgery.
- You will be advised regarding driving after surgery, as this can vary between patients. Essentially you can drive as soon as you can meet the visual standards for driving as set by the DVLA.
- How soon you can return to work will depend on your type of job and whether or not you need new glasses. Your surgeon will be able to advise you regarding this.